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What are orthotics - uselful link

Posted by Ed Davis, DPM on 7/21/05 at 22:55 (178827)

http://www.apma.org/s_apma/doc.asp?CID=371&DID=9423

Ed

Re: What are orthotics - uselful link

Ralph on 7/22/05 at 10:44 (178844)

Dr. Ed,
Thank you for the post on orthotics. When a doctor RX's orthotics to correct a foot condition how does he also take into consideration the effect that it will have on the knee and hip of the patient?

Re: What are orthotics - uselful link

Ed Davis, DPM on 7/24/05 at 09:09 (178976)

Ralph:
That is done in a couple ways. First by examining the patient as they walk so the podiatrist understands the angulational changes he/she is making. Second, the prone casting technique allows the practitioner to observe everything from the foot, ankle, leg, knee; that is observe changes in position going up the kinetic chain.
Ed

Re: What are orthotics - uselful link

Ralph on 7/24/05 at 11:49 (178984)

What about patients that are already bow legged or have knocked knees?
It would seem that they already have positioning problems with their legs.
What type of effect would realigning their feet have on their entire leg?

Re: What are orthotics - uselful link

Ed Davis, DPM on 7/24/05 at 12:05 (178988)

Ralph:
A foam box or some mat one walks over certainly cannot determine if one is bow leeged or knock kneed.

Coxa valga/ tibial varum or being bow legged kneed means that the foot is contacting more to the outside and has further to roll in to bring it to perpendicular with the ground. that individual can sprain ankles easier and may need a high lateral flange. Additonally, that person my have a greater need for a higher reafoot post (wedge).

Coxa vara/tibial valgum or being bow legged means that the individual has a heel that may be contacting more to the inside and may need a high but perprndiculat rearfoot post to prevent the heel from rolling in to much. Occasioanll a medial flange sould be used.
Ed
Ed

Re: What are orthotics - uselful link

John H on 8/02/05 at 10:52 (179732)

Ed: Clearly there are many conditions that custom fitted orthotics will be effective and perhaps even a must. PF seems to be a condition we cannot really get a handle on or even always properly diagnose. Pain can appear at various places on the foot and from the post even move around. No one can yet prove what the pain generator is in most cases of persons diagnosed with PF. Some people post about being made worse from orthotics and others have positive post. I sense that orthotics for PF is a hit and miss proposition. With PF it is much an art as a science and even then a roll of the dice. Anyone who has had PF for some years has probably tried 5 or 6 pairs or more of orthotics. For a professional athlete such as a basketball player of NFL football player I wonder if they might have more use as a prevenative measure than something that is curative.